ArticleThe journal of allergy and clinical immunology. In practice2021
Penicillin Allergy Assessment in Pregnancy: Safety and Impact on Antibiotic Use.
Article in The journal of allergy and clinical immunology. In practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- The Use of Electronic Health Records to Study Drug-Induced Hypersensitivity Reactions from 2000 to 2021: A Systematic Review.Immunology and allergy clinics of North America · 2022Pooled it
- Article
- Penicillin allergy testing in pregnancy improves maternal and neonatal clinical outcomes.The journal of allergy and clinical immunology. Global · 2026Article
- Society for Maternal-Fetal Medicine Special Statement: Assessment and management of reported penicillin allergy in pregnancy.Pregnancy (Hoboken, N.J.) · 2026Article
- Validity of PEN-FAST as a clinical decision tool in pregnant patients.The journal of allergy and clinical immunology. Global · 2026Article
- Assessment of drug allergy and determination of safe alternative medications: a retrospective observational study.Frontiers in medicine · 2026Article
- Clinical Impact and Management of Antibiotic Allergy in Pregnancy.Current allergy and asthma reports · 2025Review
- Resurgence of Syphilis: A Critical Time to Improve Access to Penicillin Allergy Evaluation.Sexually transmitted diseases · 2025Article
- Obstetric penicillin allergy evaluations.The journal of allergy and clinical immunology. Global · 2025Article
- Screening for penicillin allergy in obstetric patients to optimize guideline directed therapy.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Stewardship opportunities in peripartum infections: a review of quality improvement initiatives and future directions.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- [Drug therapy safety during pregnancy and breastfeeding].Dermatologie (Heidelberg, Germany) · 2024Article
- Antepartum vs postpartum amoxicillin oral challenge in pregnant patients with a reported penicillin allergy: A two-center prospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Beta-lactam allergy risk stratification in a maternity population in Australia: Scope for allergy de-labelling.The Australian & New Zealand journal of obstetrics & gynaecology · 2024Article
- Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study.Journal of clinical anesthesia · 2024Article
- Nonsteroidal anti-inflammatory drug "allergy" labeling is associated with increased postpartum opioid utilization.The Journal of allergy and clinical immunology · 2024Article
- Demographic characteristics associated with a penicillin allergy label during pregnancy.Frontiers in allergy · 2024Article
- Advances in terahertz metasurface graphene for biosensing and application.Discover nano · 2023Review
- Article
- Penicillin allergy delabeling: Opportunities for implementation and dissemination.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2023Review
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPenicillin and other beta-lactam antibiotics are recommended for group B Streptococcus and cesarean section prophylaxis, but approximately 10% of pregnant patients report a penicillin allergy.
objectiveTo assess the safety and impact of penicillin allergy evaluation in pregnant patients.
methodsIn this retrospective study of obstetrician-ordered Allergy/Immunology (AI) electronic consultations (e-consults) from September 20, 2017 through December 31, 2019, we reviewed the electronic health record for e-consult recommendation; patient demographic, obstetric, and allergy histories; and peripartum antibiotic utilization with indication. For patients whose electronic consultation recommended an in-person AI evaluation, testing outcomes were determined, and multivariable logistic regression models were used to compare antibiotic use between patients who did and did not receive an in-person AI evaluation.
resultsOf 389 obstetrician-ordered e-consults, 363 (93%) recommended an in-person AI evaluation; of these, 222 (61%) patients received an in-person AI evaluation. Of 220 (99%) patients skin tested, 209 (95%) had their penicillin allergy label safely removed. Compared with patients who did not receive an in-person AI evaluation despite it being recommended (n = 141), patients with in-person AI evaluation (n = 222) had reduced peripartum vancomycin (adjusted odds ratio [aOR], 0.07; 95% CI, 0.01-0.33), clindamycin (aOR, 0.17; 95% CI, 0.08-0.34), and gentamicin (aOR, 0.39; 95% CI, 0.19-0.78) use and increased penicillin (aOR, 18.0; 95% CI, 6.30-51.2) use. The fully AI evaluated patients had increased first-line antibiotic prophylaxis for group B Streptococcus (aOR, 26.9; 95% CI, 6.32-114) and cesarean section (aOR, 1.94; 95% CI, 1.06-3.52).
conclusionsIn a sample of 220 pregnant patients with penicillin allergy histories and in-person AI evaluation, penicillin allergy testing was safe and associated with significantly reduced broad-spectrum antibiotic use and increased first-line beta-lactam antibiotic use.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.